FAO consolidates a united front in fighting superbugs

The UN House in Moscow warmly welcomed the members of the Regional Laboratory Network on Antimicrobial Resistance in food and agriculture in Eastern Europe, Transcaucasia and Central Asia (EETCA) countries who had their 2nd Annual Meeting there.

The meeting supported by the FAO Moscow Office was organized by the FAO Regional Office for Europe and Central Asia together with the Central Research Institute of Epidemiology (CRIE) of Rospotrebnadzor, which has the status of FAO Reference Centre for Antimicrobial Resistance (AMR).

The event took place on the eve of the World AMR Awareness Week.

“Tackling antimicrobial resistance is an urgent need. It caused the international community, professional One Health participants, state agencies and scientific institutions, the private sector and civil society organizations to recognize AMR as one of the central themes in the Sustainable Development Agenda for the goals that concern human health and well-being,” opened the meeting Oleg Kobiakov, Director of the Moscow FAO Liaison Office with the Russian Federation.

“Understanding this need, FAO and the relevant Russian agency, Rospotrebnadzor, represented by CRIE, have been implementing a joint project in this area financed by Russia since 2017,” Oleg Kobiakov continued.

“The project is aimed at strengthening the capacity of a number of Central Asian countries, Belarus, Armenia and the Russian Federation itself in combatting antimicrobial resistance as well as expanding the cooperation between participating countries in this field.

Over the past two years of work, the established laboratory network has already produced tangible results. It proves that we chose the right the direction for making our efforts, and the invested funds paid off.”

“Today the theme of antimicrobial resistance, especially in the context of post-COVID activities, is especially significant. It really is one of the top-10 global challenges,” academician Vasily Akimkin, Director of the Central Research Institute of Epidemiology of Rospotrebnadzor, justified the urgency of the work undertaken. “According to foreign experts, this will be such a huge problem for medicine that by 2050 it could overshadow the problem of cancer and cardiovascular diseases combined.

In food and agriculture, we are just beginning to recognize the need to make prompt decisions. For us, just 4–5 years ago it was quite difficult to process a large volume of patient diagnostics. We have now overcome these difficulties, and today we can perform, in particular, genome sequencing of various pathogens.

In the past, we could only dream about obtaining the genome of a virus or a microorganism. Now we can decipher the genome of any virus or any microorganism within 3–4 days at our institute. It is not enough to just identify the pathogen, it is extremely important to know its genomics.

Studying the problems of resistant microorganisms in food, we make huge efforts and use all the capabilities of CRIE as the FAO Reference Centre for AMR. All microorganisms that come to us for research are subjected to microbiological PCR, molecular and genetic diagnostic tests, and, of course, sequencing for genome studies.

We are ready to actively cooperate not only in the practical area but also in the academic field and provide colleagues from other countries with every option for scientific publications in Russia and for defending their theses. We are open to invitations to scientific conferences as guests and speakers,” academician Akimkin concluded.

“FAO works on creating a detailed AMR map in the livestock sector across countries using the Knowledge, Attitude and Practice study model,” said Daniel Beltran-Alcrudo, FAO animal health expert. “We are focused on livestock farmers, veterinarians, veterinary pharmacies, and feed mills.”

According to the FAO expert, such studies were conducted, among others, in Armenia, Belarus, Kazakhstan, Kyrgyzstan and Tajikistan. Their goal was to establish a correlation between antimicrobial use and the manifestations of AMR.

FAO also prepared a Regional Legal Report on the results of analysis of legislation relevant to antimicrobial use (AMU) and AMR in food and agriculture in the specified countries.

Daniel Beltran-Alcrudo noted that this document laid out the results of the legal framework analysis, made recommendations to address shortcomings, and formulated proposals to improve the legislation in each country with the ultimate goal of limiting imprudent use of antimicrobials and therefore reducing the spread of AMR in the food and agricultural sectors.

Photo: ©FAO/Vladimir Mikheev

For your information: The FAO Action Plan on Antimicrobial Resistance 2021–2025 has been developed and is being implemented. The Action Plan was prepared by a multidisciplinary FAO team to ensure that all relevant dimensions are considered, including terrestrial and aquatic animal health and production, crop production, food and feed safety, genetic resources, natural resource management, risk communication, and behaviour change.

The authors of the Plan paid special attention to regulatory frameworks, standards, norm-setting and bottom-up processes of collective action. Joint work under the FAO Plan is supposed to ensure that food systems, livelihoods, and economies are better protected from the destabilizing forces of untreatable illness.

“The World Health Organization (WHO) lists AMR as one of the top-10 global health threats. Limiting the occurrence and spread of AMR is critical to maintaining the ability to treat diseases, reducing food safety risks and protecting the environment,” noted Vladimir Moshkalo, Head of the UN Environment Programme (UNEP) Russia Office. “In the next decade, AMR could lead to the reduction of global GDP by at least USD 3.4 trillion annually and push an additional 24 million people into extreme poverty.”

However, the most important aspect is not the GDP reduction but the fact that “in 2019, 1.27 million deaths worldwide were directly associated with drug-resistant infections, and 4.95 million deaths were connected with bacterial AMR,” Vladimir Moshkalo emphasized. “By 2050, this annual martyrology could reach 10 million entries.”

At the same time, one must be aware that “without effective antimicrobials, it would be difficult for modern medicine to treat even mild infections in humans, animals and plants.”

“AMR is closely linked to the triple planetary crisis of climate change, biodiversity loss and environmental degradation, as well as pollution and waste caused by human activities, unsustainable consumption and production patterns,” Vladimir Moshkalo noted. “Wider use and misuse of antimicrobials and other microbial stress factors such as environmental pollution are creating favourable conditions for the development of resistance of microorganisms both in humans and in the environment, for example, in wastewater.”

The answer to the question “What to do?” UNEP experts see, in particular, in the following: there is the need for “urgent joint efforts from all the stakeholders, especially ministries of environmental protection, to prevent and minimize environmental pollution in order to overcome the AMR crisis. The response must be based on the One Health approach that recognizes the interdependence of human, animal, plant, and environmental health.”

“At WOAH we primarily work to help countries improve animal health. This sector has been, still is, and is likely to continue being associated with large use of antibiotics, and therefore applying the One Health approach is essential,” noted Jean Perchet, Deputy Director of the World Organisation for Animal Health (WOAH) Representation in Moscow. “Disease prevention is an important part of the reduction in use of antimicrobials. If an animal is not sick, you do not need to treat it. We try to avoid stressful conditions so that animals do not become susceptible to diseases.

This tactic is about passive work on AMR. Further, we have an active part comprising four pillars. These include, in particular, supporting good governance and enhancing the capacity of veterinary services with which we work. In Russia it is the Federal Service for Veterinary [and Phytosanitary] Surveillance (Rosselkhoznadzor).

Last year we started the creation of a global antimicrobial use database in order to address AMR challenges more efficiently. You can upload to this database the reasons for using antibiotics whenever an animal is sick, detailing the method and duration of treatment.

By disseminating knowledge about potential solutions to AMR, we hope to contribute to public awareness, leading to informed actions against the spread of drug-resistant infections,” Jean Perchet concluded.

A detailed report prepared by a team of Belarusian authors (Sergey Sychik, Director, Republican unitary enterprise “Scientific Practical Centre of Hygiene” of the Ministry of Health of Belarus, and his colleagues) outlined the current problems in the republic. Among those are the following: lack of a programme-oriented approach, the development of laboratory capacity that is not sustainable enough, lack of reference strains, and slow pace of digitalization.

In this regard, Belarusian colleagues set themselves such tasks as developing a National Action Plan taking into account international experience, creating a mechanism for interagency interaction, strengthening laboratory and staff capacities, introducing digital tools, and intensifying information activities.

What is the Regional Laboratory Network? “It is a community of institutions and laboratories with the main goal of establishing regional links and synergistic, complementary and coordinated joint actions to strengthen and develop laboratory capacity for AMR surveillance in the food and agricultural sectors in countries of the region, and using existing and new AMR data for further planning of actions to reduce AMR in the region,” said Irina Vaganova, expert of the Central Research Institute of Epidemiology representing the Technical Secretariat of the Regional Laboratory Network.

The expert also presented the unified plans of the international members of the Network for the future, recorded in the Road Map for 2023–2025.

Aghasi Harutyunyan, Deputy Director of the FAO Liaison Office with the Russian Federation, told the audience that the Moscow representations of FAO, WOAH, WHO, and UNEP united as the One Health Quadripartite to coordinate the strategy regarding human, animal and ecosystem health protection intend to hold a traditional round table of key participants in the implementation of the Russian national Strategy for preventing the spread of AMR, timed to coincide with the World AMR Awareness Week, on 20 November.

Aghasi Harutyunyan highlighted the importance of outreach and awareness-raising and called on representatives of the states participating in the meeting to hold their events during the World AMR Awareness Week in order to draw attention to this topic of not only experts but also the general public.

Photo: ©FAO/Vladimir Mikheev

The meeting also featured the following speakers: Arman Gevorgyan, Director, Food Safety Inspection Body (Armenia); Sayat Baiseitov, Head, Department of Methodology and Education Centre, Republican Veterinary Laboratory (Kazakhstan); Aygul Djumakhanova, Head, Laboratory Testing Centre, Department of Disease Prevention and State Sanitary and Epidemiological Surveillance (Kyrgyzstan); Mustapho Muminov, Director, Tajik Research Institute of Preventive Medicine (Tajikistan); Nina Kulakova, Head of the CRIE Reference Centre (Russia).

BACKGROUND INFORMATION

What are antimicrobials?

Antimicrobials are antibiotics, antiviral, antifungal and antiparasitic agents that are medicines widely used to prevent and treat infections in humans, aquaculture, livestock and crop production.

What is antimicrobial resistance (AMR)?

AMR occurs when microorganisms such as bacteria, viruses, parasites or fungi become resistant to antimicrobials to which they were previously susceptible. The increasing use of antimicrobials and other microbial stress factors (for example, the presence of heavy metals and other contaminants) creates favourable conditions for the development of resistance of microorganisms.

The annual meeting of the Regional Laboratory Network on AMR in food and agriculture in Eastern Europe, Transcaucasia and Central Asia (EETCA) countries.

The two-day forum is aimed at exchanging updates on initiatives and laboratory test results in food and agricultural sectors of the EECCA countries and discussing the plan of the regional laboratory network for 2024.